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Arizona rates for HCPCS 90647

Haemophilus influenzae type b vaccine (Hib), PRP-OMP conjugate, 3 dose schedule, for intramuscular use

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.25 / $35.25 / $35.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.42 / $32.35 / $53.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.94 / $109.19 / $172.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.10 / $29.23 / $199.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.25 / $35.25 / $35.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.25 / $35.25 / $35.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.03 / $36.58 / $44.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.56 / $36.54 / $36.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.56 / $37.61 / $37.76